Health protection in prisons: the Madrid Recommendation.

At an international conference held in October 2009 in Madrid, experts in harm reduction and in the control of communicable diseases generally and in prisons agreed the Madrid Recommendation. This paper outlines the recommendations for health protection in prisons and draws attention to its call for action.

Women's health in prisons: it is time to correct gender insensitivity and social injustice.

Women form a minority group within the prisons of Europe. Prisons have been built and they are run with the needs of the majority of prisoners in mind, namely men. Evidence collected throughout Europe about women's health in prisons showed that the services provided in some countries failed to meet even basic needs of women and provided examples of considerable gender insentivity and failures to observe their human rights. Along with UNODC, a joint report was issued called the WHO/UNODC Declaration which presented the evidence and made recommendations for urgently required improvements.

Acute drug-related mortality of people recently released from prisons.

The rate of acute drug-related mortality, or overdose deaths, among prisoners in the immediate post-release period is unacceptably high. Such incidents result from many factors, including decreased tolerance after a period of relative abstinence during imprisonment and the concurrent use of multiple drugs which, with every additional illicit drug consumed in combination with opioids, nearly doubles the risk of death from opioids. Other important factors are the lack of pre-release counselling, post-release follow-up and failure to identify those at risk. Substance dependence is a chronic disorder with high relapse rates and often requires long-term continuous treatment. The deaths are preventable and a number of interventions including opioid substitution treatment reduces the risk of overdose among opioid users after release.

Mental health in prisons: great difficulties but are there opportunities?

Prisons carry a great burden of mental disability from major conditions (despite diversion schemes) to lesser forms. This article gives facts and figures which justify the call for urgent action. In the light of the WHO Trencin Statement on prisons and mental health and other reports, it lists the key aspects of an emerging new agenda for mental health and prisons.

Analysis of dynamic MR breast images using a model of contrast enhancement.

We describe a model of dynamic contrast enhancement in breast MRI designed to aid the radiologist in cases for which X-ray mammography is ineffective. The breasts are segmented from the image slices by a dynamic programming algorithm after morphological opening. A pharmacokinetic model has been derived to fit the rise in intensities after injection of a contrast agent, in a way that facilitates investigation of the effects of different models of bolus injection. The pharmacokinetic model is used in a modified Horn-Schunck algorithm to correct for motion effects during the seven minute acquisition period. The results show significant localization of tumours and enable discrimination of cancerous tissue. In particular, we illustrate the approach with an image that shows a carcinoma, whose appearance and localization are greatly improved by the registration algorithm.