Forgotten Fundamentals: A Review of State Legislation on Nutrition for Incarcerated Pregnant and Postpartum People.

Adequate nutritional intake during pregnancy is critical to infant health and development. People with the capacity for pregnancy who are incarcerated have limited control over their diets and rely on prisons and jails to meet their nutritional needs. This study examined state and federal statutes pertaining to nutrition care for pregnant people while incarcerated. Following a systematic search and review, we identified four qualitative codes relating to access to vitamins, supplemental food, additional hydration, and prenatal nutrition education. Summaries of state and federal statutes pertaining to nutrition were developed and compared with current prenatal nutrition recommendations. Less than a third of states had nutrition-related mandates and no states had statutes that included all key nutrition recommendations. No federal statutes addressed nutrition during pregnancy. Additionally, our review found no provisions for enforcement of the limited nutritional statutes that do exist. To mitigate adverse health consequences for pregnant people and their fetuses, policymakers should enact or amend legislation to align nutrition standards in all prisons and jails with national policy recommendations and provide mechanisms to oversee compliance.

Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

BACKGROUND: In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. OBJECTIVES: The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. METHODS: Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. FINDINGS: One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. CONCLUSION: The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

A Pilot Study of Yoga with Incarcerated Youth Using the Prison Yoga Project Approach.

In recent decades, there has been more significant implementation and research of yoga programs in prisons and correctional facilities. Existing literature suggests that adult and juvenile prison-based yoga programs may improve stress-management and self-regulation skills; reduce depression, anxiety, aggression, and addictive behaviors; and increase prosocial behaviors. However, yoga in juvenile correctional facilities is still understudied compared to adult populations. The Prison Yoga Project (PYP) and Yoga FLAME (Focus, Letting go, Anger management, Mindfulness, and Exhaling negativity) are two frameworks used to structure the implementation of prison-based yoga programs among incarcerated adolescents. The present study aimed to describe trauma-related stress and self-regulation levels in a sample of incarcerated youth and to explore yoga's effects on developing stress-reduction skills. The study collected measures on overall and in-session stress reduction and baseline self-regulation. Because of the COVID-19 pandemic and public-safety restrictions, the present study was prematurely terminated after 5 months. Only pre-assessment measures were collected. Across time, participants reported a 38% mean stress reduction from the beginning to the end of a yoga session. Incarcerated youth with higher initial self-regulation levels showed higher pre- to post-session improvements in stress. The present findings provide valuable evidence that yoga practice using the combined PYP and FLAME framework can deliver practical benefits to juvenile correctional facilities. Furthermore, yoga may be used to foster rehabilitation, enhance skill development, and facilitate greater success in youth transitioning back into the community.

Trauma-Informed Yoga Teacher Training: Impact on Incarcerated Men's Wellness.

In late 2021, the United States had a total of 1.2 million individuals confined in state and federal prisons, with approximately 1.1 million of these people being men. Although existing research provides evidence that engaging in yoga programs within prison settings can enhance the well-being of incarcerated individuals, with several studies supporting this claim, knowledge regarding the specific effects of participating in a yoga teacher training program during confinement is still lacking. The purpose of the present investigation was to evaluate the effect of completing a prison-based 200-hour trauma-sensitive yoga teacher training program on the perceived physical, mental, social, and spiritual wellness of men in prison. We hypothesized that men who successfully completed the training program would report notable improvements in all four dimensions of wellness. Focus groups, participant workbook reviews, and demographic surveys were used to understand how participation in yoga teacher training influenced men's perceived wellness. Participants identified a variety of wellness gains associated with yoga teacher training. These gains have the potential to contribute to improved individual health, improved relationships with others, and safer communities.

Eye movement desensitisation and reprocessing (EMDR) therapy in prison and forensic services: a qualitative study of lived experience.

Background: Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives.Objective: This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care.Method: Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants.Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis ('giving the voices something to feed on'). Second, EMDR was regarded with Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future.Conclusions: The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235.Study registration: The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682.

This study canvases the lived experiences of forensic patients receiving EMDR for PTSD ­ people whose views are seldom captured. They described being profoundly impacted by trauma, developing debilitating and enduring PTSD symptoms which variably contribute to offending and psychosis.Participants did not have favourable first impressions when they first heard about EMDR, thinking it 'quackery'. However, they were surprised and delighted by results, with the majority describing marked symptom reduction and personal transformation. Having targeted some of the underlying drivers of maladaptive behaviour, people reported hope for a better future.EMDR was well suited to a forensic setting and was seen as an empowering therapy.

Barriers and facilitators to health during prison reentry to Miami, FL.

BACKGROUND: People face numerous barriers to reentry and community integration following incarceration, and these obstacles manifest themselves as barriers to economic stability, housing security, healthcare, community acceptance, and educational attainment, ultimately leading to poor health. This study aims to understand healthcare needs of reentrants post release within the unique political and service context of Miami Dade County, FL, and seeks to uncover the structural facilitators and barriers to sustaining health during reentry. METHODS: We report on a subset of data from a larger reentry asset mapping project. We conducted a qualitative thematic analysis based on 12 semi-structured interviews with community stakeholders, including reentrants who were released in the past year (n = 5) and with community providers who have provided support services to returning citizens for at least one year (n = 7). Narratives were coded through an iterative process using NVivo software and were analyzed using the general inductive approach. RESULTS: Three themes emerged from the analysis: (1) social and structural barriers and facilitators to health during reentry, (2) challenges with medical care following release, and (3) long-term impacts of receiving poor healthcare in prison. Reentrants describe the carceral environment as non-conducive to health and cite an urgent need for systemic change within correctional institutions to promote their well-being. Respondents identified substance use disorder (SUD) treatment, trauma informed therapy, and chronic disease management as the primary healthcare needs of reentrants, and cite social support, stable housing, education, and employment as the key social and structural needs upon release. CONCLUSION: This study identifies prevalent resource gaps in Miami Dade County during reentry. Respondents advocate for more inclusive governmental housing programs, Medicaid expansion, and more holistic reentry programs to support reentrants. Understanding the barriers and facilitators to health during reentry can inform future interventions to better support reentrants in their transition post-incarceration.

A Scoping Review of Nutrition Education Interventions Applied in Prison Settings.

PURPOSE OF REVIEW: Over 11 million individuals are incarcerated globally, facing health challenges such as obesity, diabetes, and cardiovascular disease, possibly exacerbated by prison diets. The objective of this scoping review is to explore the various available types of nutrition education interventions that currently exist in the literature applied in prison settings. RECENT FINDINGS: Utilizing the PRISMA Extension for Scoping Reviews, 19 databases were searched for studies on nutrition interventions in prisons from 2000 to May 2023, guided by the "PICO" structure. Inclusion criteria encompassed articles in five languages from peer-reviewed journals focusing solely on nutrition education interventions. Rayyan QCRI software was utilized for screening and data extraction. Fifteen international studies were analyzed, covering various countries and targeting different populations in prisons. Interventions varied from nutrition education to comprehensive health programs. The outcomes were inconsistent, with some showing health improvements and others encountering challenges. Few utilized established theoretical frameworks, indicating a research gap. The range of interventions highlights the potential complexity of nutrition education interventions within prisons. Implementing recognized theoretical frameworks may enhance effectiveness. The diverse outcomes highlight the challenges in creating impactful programs, emphasizing foundational issues. Recommendations focus on rigorous research designs and understanding prison-specific complexities. Nutrition education interventions in incarcerated settings present varied results, emphasizing the need for well-structured, theoretically grounded, and carefully evaluated programs. Future strategies should recognize the multifaceted nature of correctional facilities, aiming for holistic approaches to improve health in prisons.

Integrated Safety and Health Promotion among Correctional Workers and People Incarcerated: A Scoping Review.

Improving safety and health for correctional workers and people who are incarcerated are widespread yet separate initiatives. Correctional workers and people who are incarcerated experience similar challenges involved with poor workplaces and living conditions, including mental health crises, violence, stress, and chronic health issues, and the available resources lack integration with respect to safety and health promotion. This scoping review sought to contribute to an integrated approach for correctional system safety and health resources and identify studies of correctional resources that address health promotion among correctional workers and people who are incarcerated. Guided by PRISMA, a search of gray literature, also termed peer-reviewed literature, published between 2013-2023 (n = 2545) was completed, and 16 articles were identified. Resources primarily targeted individual and interpersonal levels. At every level of intervention, resources improved the environment for both workers and those incarcerated, with trends of less conflict, more positive behaviors, and improved relations, access to care, and feelings of safety. The corrections environment is impacted by changes from both workers and people who are incarcerated and should be examined using a holistic approach. Future health and safety resources should target the larger correctional environment by utilizing practices, policies, and procedures to improve safety and health for incarcerated people and workers.

Expanding buprenorphine in U.S. jails: One county's response to addressing the fears of diversion.

INTRODUCTION: The overdose crisis continues to be a major public health emergency in the United States. While effective medications for opioid use disorder (MOUD), such as buprenorphine, have ample scientific evidence to their effectiveness, they are underutilized in the United States and particularly in criminal justice settings. One rationale against the expansion of MOUD in carceral settings cited by jail, prison, and even Drug Enforcement Administration leaders is the potential for diversion of these medications. However, currently little data exist to support this claim. Instead, successful examples from early expansion states could help to change attitudes and calm misconceptions around diversion fears. RESULTS: In this commentary, we discuss the experience of one county jail that successfully expanded buprenorphine treatment and did not suffer significant impacts related to diversion. Instead, the jail found that their holistic and compassionate approach to buprenorphine treatment improved conditions both for incarcerated individuals and jail staff. CONCLUSION: Amid a changing policy landscape and a federal commitment to increase access to effective treatments in criminal justice settings, lessons can be learned from jails and prisons that have already or are working toward expansion of MOUD in their facilities. Ideally, these anecdotal examples, in addition to data, will help to encourage more facilities to incorporate buprenorphine into their opioid use disorder treatment strategies.

Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons.

PURPOSE: This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia. DESIGN/METHODOLOGY/APPROACH: The study was conducted in Kajang prison, starting in July 2013 in the men's prison and June 2015 in the women's prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses. FINDINGS: Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232-526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48-5.68]). ORIGINALITY/VALUE: Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

Experiences of midwifery care in English prisons.

BACKGROUND: In the United Kingdom (UK), all prisoners must receive healthcare equivalent to that available in the community. However, evidence suggests that equality in healthcare provision for perinatal women in UK prisons is not always achieved. The aim of this research was to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons. METHODS: A qualitative approach based on institutional ethnography was used to research women's experiences in three English prisons over a period of 10 months. In total, 28 women participated in audio-recorded, semi-structured interviews. Ten staff members were interviewed, including six prison service staff and four health care personnel. Ten months of prison fieldwork enabled observations of everyday prison life. NVivo was used for data organization with an inductive thematic analysis method. RESULTS: Women's experiences included: disempowerment due to limited choice; fear of birthing alone; and a lack of information about rights, with a sense of not receiving entitlements. Some women reported favorably on the continuity of midwifery care provided. There was confusion around the statutory role of UK midwifery. DISCUSSION: Experiences of perinatal prisoners contrast starkly with best midwifery practice-women are unable to choose their care provider, their birth companions, or their place of birth. In addition, a reliance upon "good behavior" in return for appropriate treatment may be detrimental to the health, safety, and well-being of the pregnant woman and her unborn baby. CONCLUSION: Prison is an adverse environment for a pregnant woman. This study provides key insights into imprisoned women's experiences of midwifery care in England and shows that midwives play an essential role in ensuring that perinatal prisoners receive safe, high-quality, respectful care.

Shackling and pregnancy care policies in US prisons and jails.

OBJECTIVES: The number of incarcerated women in the United States has risen exponentially. Many are of childbearing age with 3-4% being pregnant at intake. Despite the need for comprehensive pregnancy-related health care in prisons and jails, there is no oversight that requires adherence to the established standards. The objective of this study was to assess prison and jail pregnancy policies and practices with an emphasis on restraint use and compliance with anti-shackling legislation. METHODS: We conducted a survey of 22 state prisons and six jails, including the five largest jails, from 2016-2017 regarding pregnancy policies and practices including restraint use, prenatal care, delivery and birth, and other pregnancy accommodations. We compared reported restraint policies to state legislation at the time of the survey. RESULTS: Data indicate that pregnancy policies and services in prisons and jails vary and compliance inconsistencies with anti-shackling legislation exist. A third of the prisons and half of the jails did not have accredited health care services. All study facilities provided prenatal vitamins and most provided supplemental snacks. Most facilities stationed an officer inside the hospital room during labor and delivery, but nearly one-third of facilities did not require a female-identifying officer. CONCLUSIONS FOR PRACTICE: Limited oversight and standardization of carceral health care and accommodations for pregnant people lead to variability in prisons and jails. Prisons and jails should adopt and implement standards of care guidelines to ensure the safety and well-being of pregnant people who have unique healthcare needs. Incarcerated pregnant people should be viewed as expectant parents in need of comprehensive health care, rather than as criminals who forfeited their right to a safe, respectful, and humane childbirth.

The Utility of Meditation and Mindfulness-Based Interventions in the Time of COVID-19: A Theoretical Proposition and Systematic Review of the Relevant Prison, Quarantine and Lockdown Literature.

As of July 20, 2021, Covid-19 has killed 4,086,000 people, infected at least 190,169,833 others, and devastated the world's economy. To slow the spread of the virus, numerous governments instituted "lockdown" policies and quarantines, limiting social interactions to the immediate household. The experience of isolation and uncertainty have contributed to increased fear, anxiety, and loneliness; with limited options of research-supported interventions. Although different in nature, the experiences of quarantine and lockdown have been likened to incarceration. Past research has found meditation and mindfulness-based interventions (MBIs) to be effective psychological treatments for prisoners and may therefore translate well into effective methods for the maintenance of psychological well-being for individuals quarantined during the pandemic. More recently, research investigating the effects of meditation and MBIs during the pandemic have demonstrated preliminary evidence for beneficial psychological improvements. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), the current narrative review paper: 1) examines the parallels and differences between the experience of quarantine and imprisonment, 2) investigates the mechanisms through which meditation and mindfulness enact their effects, and 3) systematically reviews literature on the benefits of various types of meditation and MBIs for inmates and individuals in lockdown or quarantine. With this knowledge, the public can garner applicable insight into the potential use of meditation and MBIs for individuals forced to cope with pandemic lockdowns and quarantines. Two hundred and twenty one (221) articles were identified through Pubmed and Google Scholar, and 24 articles were ultimately included in the manuscript.

The Effectiveness of Trauma-Focused Interventions in Prison Settings: A Systematic Review and Meta-Analysis.

BACKGROUND: Posttraumatic stress disorder (PTSD) is overrepresented in prison relative to community populations and can be difficult to manage in an environment which can inherently exacerbate trauma-related symptomology. Little is known about the effectiveness of trauma-focused interventions in prison and less is known about factors that moderate the effectiveness of these interventions. AIM/METHODS: We examined the effectiveness of trauma-focused interventions in prison relative to prison controls using meta-analytic techniques. We further used meta-regression analysis to examine treatment, methodological and participant-level moderators to determine factors that increased the effectiveness of these interventions. RESULTS: From 16 studies eligible for the meta-analysis, we found a small but significant effect size for trauma-focused interventions. Phase 2 trauma processing interventions and interventions delivered individually led to greater reductions in PTSD symptoms. Studies utilizing an active treatment control resulted in smaller effect sizes than those using waitlist or no contact controls. Treatment length, study quality, outcome type, and gender were not significant moderators of treatment effectiveness. CONCLUSION: Findings from this review are encouraging but should be interpreted with caution. Results suggest that trauma processing therapies, and individual modality trauma-focused interventions can be effective and delivered successfully in prison. However, inadequate comparison groups do not allow a firm conclusion to be drawn. There is a need for high quality Randomized Controlled Trial's that additionally measure Complex PTSD, utilize a modular treatment approach, and include treatments recommended in the National Institute for health and Care Excellence (NICE) guidelines such as Trauma-focused CBT and Eye Movement Desensitization Reprocessing (EMDR).

Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

Medidas preventivas de fatores de risco de doenças cardiovasculares no ambiente prisional: revisão integrativa / Preventive measures against risk factors for cardiovascular diseases in the prison environment: an integrative review

RESUMO Objetivo analisar as medidas preventivas de fatores de risco de doenças cardiovasculares no ambiente prisional. Métodos revisão integrativa realizada nas bases de dados MEDLINE/PubMed, Web of Science, SCOPUS, CINAHL, LILACS, EMBASE e SciELO. Os descritores e palavras-chave utilizados, combinados com os operadores booleanos OR e AND foram prisons, prisoners, health promotion, health education, cardiovascular diseases, heart diseases e heart. Foram incluídos artigos que abordassem as medidas preventivas de fatores de risco de doenças cardiovasculares no ambiente prisional, sem recorte no tempo, nas línguas inglesa, portuguesa ou espanhola. Resultados a amostra final foi composta por sete artigos. As medidas preventivas encontradas foram relacionadas a atividade física, melhora nutricional, controle do peso, cessação do tabagismo, controle do estresse e acompanhamento laboratorial, com prevalência para a atividade física e a melhora nutricional. Conclusão a identificação de medidas de prevenção pode auxiliar no desenvolvimento de ações de promoção da saúde para a população privada de liberdade, entretanto, são necessários mais estudos com esta temática. Contribuições para a prática: conhecer as medidas preventivas de fatores de risco de doenças cardiovasculares utilizadas no ambiente prisional poderá subsidiar o desenvolvimento de intervenções para promoção da saúde.

ABSTRACT Objective to analyze preventive measures against risk factors for cardiovascular diseases in the prison environment. Methods integrative review carried out in the databases MEDLINE/PubMed, Web of Science, SCOPUS, CINAHL, LILACS, EMBASE, and SciELO. The descriptors and keywords used, combined with the Boolean operators OR and AND were: prisons, prisoners, health promotion, health education, cardiovascular diseases, heart diseases and heart. We included articles in English, Portuguese, or Spanish, that addressed preventive measures against the risk of cardiovascular diseases in the prison environment, with no specific time frame. Results the final sample included seven articles. Preventive measures found were related with exercising, nutritional improvement, weight control, smoking cessation, stress control, and laboratory follow up, focusing specially in physical activities and nutritional improvement. Conclusion identifying preventive measures can aid in the development of health promotion actions for the population deprived of freedom. Nonetheless, more studies on the topic are required. Contributions to practice: understanding the preventive measures against risk factors for cardiovascular diseases used in the prison environment can give support to the developing of health promotion interventions.

Encarceramento feminino: um debate entre criminologia e perspectivas feministas / Female incarceration: a debate between criminology and feminist perspectives / Encarcelamiento femenino: un debate entre la criminología y las perspectivas feministas

Este ensaio teórico-reflexivo tem como objetivo discutir sobre as contribuições dos estudos da criminologia e sua crítica para as diversas formas de aprisionamento feminino, e mais atualmente para o encarceramento em massa no sistema prisional, além de abrir espaço para o debate sobre as diferentes perspectivas feministas e as relações com os estudos criminológicos, sobretudo com os posicionamentos da chamada criminologia crítica. Reconhecem-se importantes avanços e conquistas feministas no debate sobre a estruturação masculinizada do direito penal e do seu fazer jurídico, mas também a manutenção de diversas formas de violência de gênero que configuram um sistema penal antropocêntrico, seletivo, racista e discriminatório. Indica-se a urgência de estudos interseccionais que considerem as particularidades e reinvindicações das mulheres no cárcere e suas formas de militância, sobretudo diante de população carcerária feminina composta majoritariamente por mulheres negras, pobres e periféricas. Faz-se visível a necessidade de uma análise dos fatores que atravessam o encarceramento feminino por uma ótica feminista plural, adequada às realidades que se estudam e atenta às múltiplas perspectivas que podem existir dentro do feminismo.(AU)

This theoretical-reflexive essay aims to discuss the contributions of criminological studies and their critique of the various forms of imprisonment of women, and more recently of mass incarceration in the prison system, in addition to opening space for the debate on the different feminist perspectives and their relations with criminological studies, especially with the positions of the so-called critical criminology. Important feminist advances and conquests are recognized in the debate about the masculinized structure of penal law and its legal practice, but also the maintenance of diverse forms of gender violence that configure an anthropocentric, selective, racist, and discriminatory penal system. It indicates the urgency of intersectional studies that consider the particularities and claims of women in prison and their forms of militancy, especially in the face of the female prison population composed mostly of black, poor, and peripheral women. The need for an analysis of the factors that cross women's imprisonment from a plural feminist perspective, adequate to the realities under study and attentive to the multiple perspectives that may exist within feminism, becomes visible.(AU)

Este ensayo teórico-reflexivo pretende discutir las aportaciones de los estudios criminológicos y su crítica a las distintas formas de encarcelamiento femenino, y más recientemente de encarcelamiento masivo en el sistema penitenciario, además de generar debate sobre las distintas perspectivas feministas y sus relaciones con los estudios criminológicos, especialmente con las posiciones de la Criminología Crítica. Se reconocen importantes avances y logros feministas en el debate sobre la estructuración masculinizada del derecho penal y su práctica jurídica, además del mantenimiento de diversas formas de violencia de género que configuran un sistema penal antropocéntrico, selectivo, racista y discriminatorio. Se necesitan estudios interseccionales que consideren las particularidades y reivindicaciones de las mujeres en prisión y sus formas de militancia, principalmente ante la población penitenciaria femenina compuesta mayoritariamente por mujeres negras, pobres y periféricas. Se hace evidente la necesidad de analizar los factores que inciden en el encarcelamiento femenino desde una perspectiva feminista plural, adecuada a las realidades que se estudian y atenta a las múltiples perspectivas que pueden existir dentro del feminismo.(AU)

From Cognitive Behavioral Therapy to Mindfulness-Based Interventions.

The U.S. Department of Justice indicates that 83% of individuals released from state prisons in 2005 were arrested at least once during a 9-year follow-up period. With only 17% of released individuals not rearrested, it could be argued that correctional facilities fail to provide the necessary resources that individuals need for proper rehabilitation and reintegration. Thus, there is a need for alternative jail and prison programming. This article reviews the leading program, cognitive behavioral therapy, and advocates for the integration and use of mindfulness-based interventions (MBIs) in carceral settings. Specifically, this article reviews the literature on MBIs and their significance in corrections.

The relationship between self-forgiveness and psychological wellbeing in prison inmates: The mediating role of mindfulness.

BACKGROUND: Previous research with general population samples has consistently shown that forgiveness and mindfulness facilitate coping with distressing experiences and significantly promote mental health. No study, however, has examined their unique contribution to prisoners' psychological wellbeing nor has considered the different forms of self-forgiveness among prisoners. AIMS: Our aim was to investigate the role of mindfulness in mediating any association between prisoners' self-forgiveness and psychological wellbeing and to test whether any such links are moderated by years spent in prison. In this study self-forgiveness was conceptualised as a multidimensional construct, including presence of genuine self-forgiveness, absence of pseudo self-forgiveness and/or absence of self-punitiveness. METHODS: Participants were recruited from a prison in Northern Italy. Consenting men were asked to complete an anonymous self-report questionnaire with only a researcher present. RESULTS: 104 male prisoners (mean age 46.63 years, SD 11.38) took part. Findings were that self-punitiveness was inversely related to well-being, with mindfulness mediating this relationship, this while controlling for the other dimensions of self-forgiveness and the perceived severity of the crime committed. Contrary to expectation, we found no direct relationship between genuine self-forgiveness and well-being, but the moderated mediation models showed that genuine self-forgiveness was positively associated with mindfulness and, through this, had an indirect association with wellbeing, significant only for prisoners who had already spent several years in prison. CONCLUSIONS: Our findings confirm that self-forgiveness is a complex construct, worthy of further investigation among offenders. They suggest that forgiveness interventions for prisoners should include modules aimed at primarily reducing self-punitive attitudes. Promotion of genuine self-forgiveness should be tried only with awareness that this is likely to take a very long time. In such circumstances, interventions may promote energy to be invested in mindful processes with a consequent improvement in psychological wellbeing.

Understanding health and social service accessibility for young people with problematic substance use exiting prison in Australia.

Incarcerated young people (aged 18-24) with a history of problematic substance use are a particularly vulnerable group, with a higher risk of mortality and return to custody compared to their older counterparts. Yet, there is limited research investigating service accessibility for this population. This study aimed to address this gap by investigating the characteristics of young people exiting prison on the 'Connections Program' (Connections) and their access to support services. Connections is a transitional program with a remit to link people with problematic substance use exiting prison in New South Wales, Australia, to health and social services in the community. We used an explanatory sequential mixed methods approach including (1) a retrospective cohort study of young people on Connections (n = 359), utilising self-reported data collected in a routine pre-release questionnaire from January 2008 to February 2015 and (2) a qualitative survey with Connections caseworkers (n = 10). In stage one, descriptive statistics were calculated to produce a profile of sociodemographic and health characteristics of young people with problematic substance use exiting prison. In stage two, qualitative data were thematically analysed to explore the accessibility of services to meet young people's needs from the perspective of caseworkers. The study found young people experienced substantially poorer mental health than the general population, and the vast majority had received treatment for a mental health issue (96.5%). Illicit substance use prior to incarceration was common (91.5%). Caseworkers reported substantial barriers to service accessibility in the community related to intersecting social disadvantage and co-occurring mental distress and substance use. Caseworkers have front-line knowledge of how gaps and barriers in services impact transition from prison and identified longer-term case coordination, inter-agency collaboration and holistic care as vital strategies to support young people in transition from prison to community.